Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mallory Brooke Moody, PA

Individual provider Physician Assistant · NPI 1710612718

Mallory Brooke Moody, PA is a Physician Assistant in Millington, Tennessee. Qualified in 2022, 4 years ago. Practices with Hamad Ahmad MD PC, a 13-clinician group and accepts Medicare assignment.

Years since qualifying
4
In the registry since
2022
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

4772 Navy Rd Ste A
Millington, TN 38053-1957
Phone: (901) 873-0930
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X

Record details

NPI number1710612718
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedJuly 22, 2022
Last updated in NPPESJuly 23, 2024
Certification dateJuly 23, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Hamad Ahmad Md Pc — 13 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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